Recently, if there is pulmonary hypertension in ventricular septal defect, early operation without pulmonary artery banding is recommended even though patient is under l year in age or has low body weight. We also had been performing operations
under
the above mentioned policy.
From October 1986 to December 1995, eighty eight cases of ventricular septal defect under 10Kg in body weight were operated upon by open cardiac surgery. Mortality was compared by age, body weight and degree of pulmonary vascular hypertension.
Total mortality was 10cases(11.4%); under 6months, the mortalty was 5 in 14 cases(35.8%), from 6 months to lyear, 4 in 43 cases(9.3%) and over l year, one in 31 cases(3.2%), while there was no significant difference in mortality compared by
degree
of
pulmonary vascular hypertension. And mortality under 6months in age was so high regardless of severity of pulmonary hypertension. After this exprience, too early operation, especially under 6 months, should be considered very prudently, unless
there
were life threatning heart failure, impending irreversible pulmonary vascular bed change or failure to thrive.
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